Written by Colin Wood
The monkeypox virus has “overwhelmed” the aging technology infrastructure of several local health jurisdictions in Washington, further straining a workforce that state health officials said was already feeling burned out from a two-and-a-half-year response to the COVID pandemic. -19.
When the Centers for Disease Control and Prevention did MPV a reportable condition On Aug. 1, the virus joined dozens of other diseases and conditions that state and local health jurisdictions are responsible for monitoring. It created an additional burden for local health authorities across the country, which are often understaffed and have little technology or technology training, said Elizabeth Perez, a spokeswoman for the Washington Department of Health.
“The entry is through local health departments, and local health departments can get overwhelmed very, very quickly,” she told StateScoop.
Perez said that before joining Washington State, she worked long hours The covid pandemic for a local health agency in Harris County, Texas, which surrounds Houston, where she said offices sometimes processed 300 faxes a day, rather than relying on digital platforms.
HPV, which is more difficult to transmit than COVID-19 and has generated far fewer cases, has nevertheless placed an administrative burden on local health offices, said Michelle Campbell, director of the new office of health systems. data and modernization of the Washington Department of Health.
“When the guidance came out from the CDC for the MPV interview questions, it included 150 new variables that didn’t exist in our core surveillance system,” she said.
Campbell said Washington’s Disease Reporting System is currently being upgraded to accommodate more information on language and ethnicity, so the state turned to an online application called REDCap to collect the MPV survey data. But this, she said, has also taxed local authorities, who are not always experienced in using this platform or are not at all designed to collect digital data. It has also created inconsistencies in data collection.
“Because they haven’t had time to build the infrastructure, the information is not being consistently captured in the various counties that are affected,” Campbell said. “There is a fair amount of manual work that needs to be done in reconciliation if there are duplicates, based on receiving an investigation and electronic lab report. It just takes a lot of manpower and a lot of time when the staff who are supporting the MPV, at the state and local level, all have to do the same work they’ve been doing for COVID for the last two years. years. It’s a really burned out workforce at this point.”
Campbell said the CDC is aware of these problems. And the federal agency is currently funding investments in local technology and training. CDC epidemiology grants and laboratory capacity have poured billions of dollars into local health authorities during the pandemic. And in June, the CDC announced its “Strengthening US Public Health Infrastructure, Workforce and Data Systems” program, which will provide nearly $4 billion for professional development and technology modernization, including 900 million dollars to strengthen data technology and infrastructure.
But Campbell said funding for the new technology isn’t keeping up with the need, and that the CDC’s restrictive funding model — which only allows agencies to spend any awards under narrowly defined program areas — has made it difficult to develop enterprise technology systems that naturally include various programs.
“We’ve had to do a lot of gymnastics to make good use of our data, and that funding model hasn’t really changed,” she said. “Until we can get funding that supports the public health enterprise and are able to do things in a way that is sustainable financially and also in terms of staffing, we really need our federal partners to take an approach that considers it from this perspective.”
The ELC grants, however, are allowing Washington state to design a new training program that it hopes fills a lack of data science knowledge among epidemiologists, who are more often trained in other skills, Campbell said.
“The different tools and programming languages that really make it easier to work with large volumes of data and to do those analyzes and gain insights, it’s just not what [epidemiologists] they are trained when they are in college,” she said. “They’re more focused on analyst tools, which really aren’t designed for this large volume of data.”
Campbell said her office, which was created in June primarily to address a lack of sophisticated technology used by public health authorities, is working with the University of Washington to design a training program that provides basic food science skills. data for public health officials.
“We’re starting to lose staff to attrition — just a lot of burnout. Then you end up short staffed,” she said. “The lack of sophisticated technology is part of that because it requires so much human intervention to get the job done.”